CMS announces payment amounts for Round 2

BALTIMORE - CMS announced today that reimbursement rates for certain home medical equipment will be, on average, 45% lower than the current fee schedule as part of Round 2 of competitive bidding.

Medicare beneficiaries will save, on average, 72% on diabetic testing supplies as part of the national mail-order program.

The CMS Office of the Actuary estimates that the program will save the Medicare Part B Trust Fund $25.7 billion and beneficiaries $17.1 billion between 2013 and 2022.

“This program has already saved millions for taxpayers and beneficiaries while maintaining access to care,” stated CMS Acting Administrator Marilyn Tavenner. “We look forward to building on this success by serving more beneficiaries, increasing savings and helping to ensure the long-term sustainability of Medicare.”

Round 1 of competitive bidding saved Medicare about $202.1 million.

CMS's next steps:

•    It will now begin the contracting process.

•    In the spring of 2013, it plans to announce the contract suppliers.

•    On July 1, 2013, it plans to go live with the payment amounts and contract suppliers.

For single payment amounts: http://www.dmecompetitivebid.com/palmetto/cbicrd2.nsf/DocsCat/Single%20Payment%20Amounts

For CMS's press release:

http://www.cms.gov/apps/media/press/release.asp?Counter=4512&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=1%2C+2%2C+3%2C+4%2C+5&intPage=&showAll=365&pYear=&year=0&desc=&cboOrder=date

For CMS's fact sheet:

https://www.cms.gov/apps/media/press/factsheet.asp?Counter=4513&intNumPerPage=10&checkDate=&checkKey=&srchType=1&numDays=3500&srchOpt=0&srchData=&keywordType=All&chkNewsType=6&intPage=&showAll=&pYear=&year=&desc=&cboOrder=date

Round 1 and Round 2: How do they stack up?

ROUND 1

Round 1 of competitive bidding was implemented on Jan. 1, 2011, in nine cities for nine product categories. In Round 1, single payment amounts were, on average, 32%, below the current fee schedule. For oxygen concentrators, for example, the single payment amount was $116.16 per month, reduced from $173.17.

ROUND 2

CMS plans to implement Round 2 on July 1, 2013, in 91 cities for eight product categories:

•    oxygen supplies and equipment;

•    standard manual and power wheelchairs and scooters and related accessories;

•    enteral nutrients, equipment and supplies;

•    CPAP devices, respiratory assist devices and related supplies and accessories;

•    hospital beds and related accessories;

•    walkers and related accessories;

•    support surfaces; and

•    negative pressure wound therapy pumps and related supplies and accessories).

ROUND 1 RE-COMPETE

CMS also plans to implement a Round 1 re-compete on Jan. 1, 2014, in the same nine cities as Round 1 but for an expanded number of product categories. The agency has combined several smaller product categories into larger categories—a general HME category, for example, covers everything from urinals to patient lifts to TENS devices.

See also: CMS changes name of bidding game

Repeal and replace

Industry stakeholders plan to reintroduce a bill to repeal and replace competitive bidding with a market-pricing program (MPP) in the coming weeks. A previous bill in the 112th Congress, H.R. 6490, garnered 94 co-sponsors.

See also: Price breathes new life into MPP